Enzo,
You have a great start with observing medicines that smell horrible all the way to the end dogs seem to go for first. When Phydough , my French poodle, sees a new animal she has already assessed it with her powerful nose. So what on earth is Phydough doing when she jumps up on the bed and starts tonguing snot out of my nose? And what is so dang interesting about the bottom of my ass today that wasn’t there yesterday?
We are poop watchers one and all. As Phydough was evaluating my wellbeing with her nose and maybe her tongue, but she also eats other dog’s poop so that really isn’t it that, you get what I mean…… Whooh! Ok, got my breath. Phydough’s nose tells more than our eyes at a certain sensory level. They check out other animals to evaluate their mood, health and pet status not to mention evaluating it for vulnerabilities in case it is hostile. Thank goodness I really don’t have a dog!!!
Our bowel habits and our stool (poop) is a great indicator of health. In fact a really normal stool seems to happen when you give your gut a break from enzymes. I really don’t know if this is good or bad for me and you but I forget to take my enzymes or even my nightly pills on occasion and I get these marvelous turds for a day or two. I wonder just as you do what this all means. I challenged every doctor I could with this question and the best had admittedly great guesses. Here are some good assumptions to go on.
It does mean that your gut is as healthy as it probably can be. As you know, one of the things already attacked by enzymes was some of your yummy pancreas. This in part is why we become PI, or pancreatic insufficient. Pancreatic autodigestion is the medical term for the pancreas being digested by the very enzymes it produces. The point is autodigestion can be chronic like mine taking decades to really show damage or within hours after being born. Because the eat-to-poop cycle can take days, it is tricky to figure out how much enzyme is too much. Doctors know how to tell if you are taking too little or too much and it is pretty straight forward, so pester your enzyme prescriber to explain how to determine the best guess on taking enzymes. Enzymes start in your saliva with amylase or starch (amlyose) reduction enzyme. Enzymes come from many sources and reduce specific food types. Proteins are broken down by protease and so forth so there is a clue in most enzyme names, most of which end in “-ase”. Fats or lipids maybe reduced or broken down by lipase, this is what lipase in Creon reduces, so what’s with bile?
Any good Italian keeps stale olive oil at the sink for repurposing. It is better than soap and many people prize it for degreasing. After a hard night of stealing catalytic converters how do you get that grime off before school? Oils dissolve grease which dissolves wax and…. this is what bile is and does to that cool marbling in red meat. So when grammar crimes are committed over enzyme and enzymes, assume I mean the plural as in Creon and its several different enzymes. The reason your stool smells is very close to an alien source of enzymes. There are parts of plants and animals that can’t be fully digested or reduced to nutrients by all our digestive efforts. Three foreign invaders are fighting an exotic space battle in your large intestines. Bacteria, Yeasts and molds are living off of our leftover food and living to fight another day. At night, they stink up the camps with cooking and digesting and farting and so on…. So now you know, it’s war you smell kid. Thousands of different types of these critters add up to about all we can get out of food with their especial help, including their exotic enzymes.
The part we don’t see so fast is malabsorption, a form of starvation. Doctors know too little enzyme is dangerous because those enzymes break down a special class of nutrients called oil soluble vitals. If you take vitamins chances are they too are really expensive since they contain specially made nutrients that absorb with or without enzymes. The one really big problem I have from the late in life CF diagnosis is disease from all the years my body was starved. Calcium for example, which I had plenty of in my food, was not adequately absorbed because of other missing ingredients my body needed to give me those strong bones from milk and what not. Because of this and other vitamins and minerals that didn’t get processed by enough enzymes for over sixty years,has left me with useless knarled clubs I used to play the accordion with. Enzymes stink but so do the consequences of too little too late.
Ok, you can see that your poop and probably you seem much better. The downside is malabsorption and you can’t just take more vitamins in place of less enzyme, so you know why you need enzymes. Also to a degree, your doctor is guessing at managing your enzyme intake. Too much or too little of anything is to be avoided so moderation is very important. Maybe there is something in taking a break for a day or two, ask the doctor when you see him/her next. My guess is they can only guess so be prepared to filter bull crap.
Don’t hate doctors, I really don’t either, but I can’t resist poking fun at all the poker faced guessing doctors do so well. It is hard to do, so appreciate that and then start mining them for information. Consider your doctor’s knowledge a Facebook friend and swipe all the skinny you can. I know for a fact* that the exam rooms at my doctor’s office are filled with amnesia gas so that all my questions are immediately forgotten. Write questions in a list so you can get at least some questions asked and answered.
Doctors love to answer questions in spite of their protests, as long as it aids their patient. All patients and all doctors are mortal so a lot of medicine comes down to life and death eventually. Even thrilling or fright gets boring in excess. It is a relief when a fresh, curious patient is anxious to get educated so he or she can independently manage ongoing medical issues.
Too many patients like you will make the complacent patients look bad. You do need to keep your parents informed of odd or new issues. It seems you have no choice with enzymes so this is one to manage with your doctor. Cough, poop or pee blood and let them in on it right away and so on. Craft your questions carefully or you may get too much or too little focus on the point in your question. Don’t ask about good poop when you really are just tired of gagging enzymes. Ask either how to eliminate the stench of the medicine or how to analyze and manage your enzyme intake properly with the least amount.
Examples of how I form my questions: Have you asked if you are being given too much enzymes? Do you and your doctor know about fibrosing colonopathy, an outcome from too much enzyme in the bowels? Does too much enzyme hurt the same as too little?: Explain where my transverse colon really is, I think the diagrams are wrong. Study your questions to make sure you are getting to the answer you need or want to understand.
You nailed a good stool so you must know to look for floating or an oil film on the water. These are marks of incomplete digestion and you might feel a gassy stool sooner than see it, with practice. That oil film is pretty obvious in what isn’t being digested right and it very well might have a distinctive odor so be observant. If poop awards were given, what would really be ideal characteristics? Too soft or watery and you might be redefining the word “surprise”, but what if it hardens like a log? Oops, that is the direction from soft, sticky, toothpaste like stool to a rock hard, bunghole ripper.
These complex equations are easily formulated in our great brains if we predict or extend the worst/best possible limits to a problem.
Stay curious even after you are certain. *If time has taught me anything, it is most facts will be disproven some time in the future.
LL
